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shin splints, runners

Shin splints: The runner’s disease

Shin splints can be a like a disease for many athletes, getting worse and worse until it eventually kills their training and competition aspirations. Fortunately though, there are a number of exercises designed specifically to help strengthen the specific area to help reduce the risk of shin splints.

The shin splints exercise manual

1. Wall Shin Raises

Simply stand with your back to a wall, with your heels about the length of your feet away from the wall. Then, lean back until your buttocks and shoulders rest against the wall. Dorsiflex both ankles simultaneously, while your heels remain in contact with the ground. Bring your toes as far toward your shins as you can, and then lower your feet back toward the ground, but do not allow your forefeet to contact the ground before beginning the next repeat. Simply lower them until they are close to the ground, and then begin another repetition. Complete about 12 to 15 reps.

Once you have finished the reps, maintain your basic position with your back against the wall, dorsiflex your ankles to close to their fullest extent, and then quickly dorsiflex and plantar flex your ankles 15 times over a very small range of motion (smaller than the nearly full range you use for the basic reps; the emphasis here is on quickness). These short, quick ankle movements are called pulses.

As you gain strength over time, make the wall shin raises progressively more difficult by advancing from one set of 15 reps to two and then three sets of 15 (for the basic raises and the pulses). It's OK to walk around for 15 to 30 seconds between sets.

Now the single-leg raise

Once you can quite comfortably complete 3 x 15 of the double-leg raises (both basic and quick), progress to the single-leg wall shin raise. The basic position for this exercise is as before, except that you begin with only one foot in contact with the ground; the other foot rests lightly on the wall behind you. Now, full body weight is on one foot - as it is during running - as you carry out the overall routine, and the exercises are considerably more difficult. Begin with 12 to 15 reps per foot (both for the basic exercise and pulses), and progress to 3 x 15 (basic and pulse) on each foot as your strength increases. There's no need to rest between sets; simply carry out 15 reps on one foot plus the pulses, shift over to the other for 15 repetitions and pulses, return to the original foot, and so on until you have completed three sets with each foot.

2. Heel Step-Downs

These are simple but devastatingly effective exercises for preventing MTSS. Begin with a natural, erect body position, with your feet about shoulder-width apart, and then step forward with one foot. The length of the step should be moderate - as though you were walking in your normal manner. When your heel makes contact with the ground, stop the foot from fully plantar flexing, ie, use your shin muscles to keep the sole of the foot from making contact with the ground. After heel contact, the ball of your foot should descend no more than an inch toward the floor or ground; your foot is held in check by the eccentric contractions of your dorsiflexors (shin muscles). Return your foot to the starting position (back by the other foot), and repeat this basic stepping action a total of 15 times. Then, shift over to the other foot and complete 15 steps. As with the wall shin raises, progress to three sets of 15 reps over time.

Now with longer steps

Once you have mastered the basic heel step-downs, perform the same exercise - but with dramatically longer steps. Using lengthier steps will increase the accelerating forces placed on the dorsiflexors and force them to work more forcefully and quickly, as they must do during running. Start with one set of 15 reps of long steps per foot, and progress to 3 x 15 on each foot over time.

Finally, you will be ready to carry out the heel step-downs from a high step, which will increase the forces on your shin muscles to the greatest extent - and build the greatest amount of strength. Use a bench or exercise platform which is about four inches off the ground to carry out your stepping. Aside from beginning each step from a bench, your movements are the same as they are in the basic step-downs; the idea is to land on the heel of the forward foot and then to use the shin muscles to prevent the sole of the foot from making contact with the ground (again, don't let the ball of the foot move downward by more than an inch). The actual length of the step is moderate at first (you can progress to long steps later). As before, begin with 15 reps per foot, and progress to three sets of 15 reps as you gain strength and coordination.

Both the wall shin raises and heel step-downs can be carried out three to four times a week, along with your other strength-building exercises (you can complete them more often if you've had lots of problems with MTSS in the past; don't do them to the point of pain, however).

Warm up to stronger shins and avoid shin splints

The following portion of the shin-splint-preventing routine can be completed during the warm-ups preceding your regular workouts. The prescribed exercises develop shin strength and resiliency, as well as overall ankle coordination, and thus are great antidotes for your ankles' desires to begin hurting during strenuous training. It's also a good idea to include the exercises in your warm-ups; doing so transforms the warm-up from humdrum routine into an important strength and coordination session. Here's what to do:

Shin splints prevention warm-up 1. Walk on your toes with your toes pointed straight ahead for about 20 metres, getting as high up on your toes as you possibly can. Your legs should be relatively straight as you do this, and you should - at least initially - take fairly small steps.

Then, cover 20 metres high up on your toes, but with your toes pointed outward. Your legs should rotate outward from the hips when you perform this movement; don't merely turn each foot at the ankle - the whole leg is involved.

Finally, walk 20 metres high on your toes, but with your toes pointed inward. As you do so, rotate the entire leg in from the hip, not just the ankle. Repeat each of these activities (toes pointed ahead, toes pointed out, toes pointed in) at least one more time before going on to the second exercise.

Shin splints prevention warm-up 2. Walk on your heels with your toes pointed straight ahead for about 20 metres, getting as high up on your heels as you possibly can. Your legs should be relatively straight as you do this, and you should - at least initially - take fairly small steps.

Then, simply proceed as you did with the toe walks, walking 20 metres on your heels with toes pointed outward and then 20 metres on heels with toes pointed inward. Repeat each of the heel walks (toes straight ahead, toes pointed outward, toes in) at least one more time.

As the toe and heel walks become easy for you, graduate to doing the three variations of each exercise while jogging lightly, instead of walking! At least at first, you should make certain you are on a padded or grassy surface when you jog on toes and heels.

Shin splints prevention warm-up 3. Skip for 20 metres, landing in the mid-foot area with each contact with the ground, and with toes pointed straight ahead. Then, do the same, but with toes pointed out for 20 metres, and then with toes pointed in for 20 metres. Repeat the sequence at least one more time.

Shin splints prevention warm-up 4. Then, get well up on your toes and skip for 20 metres with toes straight ahead, pointed out, and pointed in.

Now skip on your heels

Once the skipping exercises are comfortable, try some light skipping on your heels. Gradually build up your ability to heel-skip with toes straight ahead, pointed out, and pointed in for 20 metres at a time. Heel skipping is a great way to build dorsiflexor strength, but carry it out only on a padded or grassy surface to avoid impact injury to your heels.

Shin splints prevention warm-up 5. Once you've completed your walking, jogging, and skipping routines, it's time for rhythm bounding. This isn't the kind of bounding you're probably envisioning - we don't mean progressing forward with extra-long strides, at least not at first. Rather, you should jog along with very springy, short steps, landing on the mid-foot area with each contact and springing upward after impact. As you rhythm bound, your ankles should act like coiled springs, compressing slightly as you make your mid-foot landing and then recoiling quickly - causing you to bound upward and forward. Move along for 20 metres or so with these quick, little, spring-like strides, alternating right and left feet as you would during running. After 10 to 20 metres of regular jogging, rhythm bound for 20 more metres, alternating three consecutive spring-like contacts with the right foot with three with the left. After 10 to 20 more metres of regular jogging, close the set by bounding along for the full 20 metres on your right foot only, followed by 20 metres on the left (making certain that you land on the mid-foot area with each ground contact and that your ankle area, not your knee or hip, is doing most of the work). Make sure (at least at first) that all of this is done on a padded surface or soft grass. As you become stronger and more skilled, you can increase the length and amplitude (vertical height) of each bound and include additional sets of bounds (work your way up to four sets).

Shin splints prevention warm-up 6. Complete some 'dorsiflexion bounces'. To do these, simply begin jumping vertically and repetitively at close to maximal height, landing in the mid-foot area with both feet and then springing upward quickly after each contact with the ground. The interesting part of this exercise is that you should dorsiflex your ankles - pulling the tops of your feet toward your shins - on each ascent, before plummeting back toward earth and plantar flexing your ankles just before making contact with the ground. Do 10 dorsiflexion bounces, rest for 10 seconds or so, and then repeat. Over time, you can add additional sets and increase the number of reps to 30. When you are really strong and skilled, perform this exercise on just one foot at a time, but only on a low-impact surface.

Shin splints prevention warm-up 7. Finally, carry out rhythm bouncing. Rhythm bouncing is actually just jumping around, but what jumping! You should start with 10 jumps in place, moderately fast, with medium height, and with maximal motion at the ankles - but little flexion and extension at the knees and hips (over time, you can work up to 30 jumps). Then, after resting for a few seconds, change the amplitude (height) of your jumps to less than an inch, and complete 20 jumps as fast as you possibly can (pretend that your feet are hitting a hot stove - so that you must minimize your impact time with the ground). Again, almost all of the action should take place at your ankles, not at your knees and hips. As you become more skilled, work up to 40 quicksilver jumps.

After resting for a few seconds, complete five 'high-impact' jumps, increasing the amplitude (vertical height) of your jumping as much as possible. Over time, progress to 30 of these maxi-jumps.

So far, all of the rhythm bounces have been carried out in place, so make things interesting by jumping forward and then backward as quickly as possible. After you have made 20 'contacts' (each time your feet strike the ground is one contact), rest for a few seconds and then jump from side to side for 20 contacts. Rest again, and then jump in a direction which is about 45 degrees from straight ahead, alternating directions (first towards the right, then towards the left) for 20 contacts as you move ahead in a zig-zag manner. Remember to use your ankle muscles to propel you, not the big muscles at the knees and hips.

As you gain skill and strength, you can increase the number of sets of each type of rhythm bouncing from one to three, and then - the fun part - carry out each type of bouncing on one foot only. Moving in different directions as you bounce increases the ability of your shin muscles to handle all of the forces created during running - the side-to-side and rotational stresses, in addition to the less-overlooked front and back forces.

Shin splints can be a terrible pain both literally and metaphorically when it comes to training and improving performance. Our shin splints exercise programme should help you overcome the pain and ensure it never comes back to bite you again.

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